HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONI
All APPLICABLE INFP MUST BE COMPLETED FOR APPLICATION TO BE ACCEPT
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2/
Date: Permit Number:
SCANNEDBY
RECEIVED
St. Lucie County -
MAR 21 2019
Building Permit Applicatio
Lucie County, Permitting
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT TYPE: dtb
I�iI� s�i�A'hiyf�17Y��LPi
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PROPOSED IN
PROVEMENT.LOCA1It?N
Address: CW--13 1i LLIi-TIRIV1✓
Property Tax ID #: -moo) _ OC7�� " c':- 70 —S
Lot No.
Site Plan Name:
Block No.
Project Name: fi%ESI7JE
DETAILED DESCRIPTION OF WORK,
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)'r.15T�L� �J Vic( �6LT- �Sil t�S
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CONSTRUCTION INFORMATION:``
Additional work to be performed under this permit -check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _Shutters
—Windows/.Doors
_ Electric _ Plumbing _ Sprinklers _ Generator
Roof % Pitch
- ` Total Sq. Ft of Construction: A Ql Sq. Ft. of First Floor: -34
\ m
Cost of Construction: $ Utilities: _Sewer _Septic
Building Height:
OWNER/LESSEE4',
CONTAG70R:
R�•
�_ `,•.
._
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Name Name:
AddressAcIS y GrdllC ,TINE Company:
City: #J�r-PIC-SIC1& State(PAddress:
Zip Code:#33r �ccv), Fax: City:
State:_
Phone Noe 5' `LI-a — 0/WS5 Zip Code:
Fax:
E-Mail: ,2r1.4S'11 )0fZ (D.(Ib*,r) Phone No Q I
Fill in fee simple Title Holder on next page (if different E-Mail�,�1
from the Owner listed above) State or County License71iw!,
�L VtSP
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. tpY -.t0 Mey1ro Lo o
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
,,i
DESIGNER/ENGINEER: Not Applicable
Name: v E C,J 1)1 )
4Address:
a
MORTGAGE COMPANY:
Name:
;
Not Applicable
Address '.02fl5 i4ASLllj.`iyTa
State. l-(,—
Zip: 33LLkb 5 PhonA I—S�24 - n>T--
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOl[DER: _ Not Applicable
Name: 3ons�d�l Syp=Q
BONDING COMPANY:
Name:
Not Applicable
Address: 3)4a3 l+ IESs" LAC T?
Address:
City: 4:"P) ice£
City:
Zip:3L- 5T3::) Phone-5Q -3-1i2)- o`c33'
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions whick may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-resideP tial use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording vour Notice of Commencement. . 'r
*N==� A
Sigi![X:QnP fawn r ssee/ o
actor as m for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
r
STATE OF FLORIDA
COUNTY OF,
COUNTY OF
The for oing instrument wa acknowledge before me
MAfn�it
The forgoing instrument was acknowledged before me
this day of
20 by
this _ day of 20_ by
ow R-�LAX
Name of person making stateniefit.
Name of person making statement.
/
Personally Known OR Produced Identification V
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
i
^'
(Signature of Notary Pub c '
3dsagrda tiorida-Notary Public
(Signature of Notary Public -State of Florida) '
Commission S GG 207484
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Commission No. g , ,. r ly(SC�o.�ymission Expires
° �w 99Ma 12, 2022
Commission No. Seal
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Rev.9/2b/2.8